Silver MicroSystems   D O O R   R E G I S T R A T I O N   F O R M

   TO:  David Wagner                                Date __/__/__
        6 Crest Park Ct.         
        Silver Spring, Md
               20903-1305

       (Please use capitalization and punctuation where necessary.)
 FROM:  SysOp Name in Makewild : __________________________________
        BBS Name in Makewild : ____________________________________
        Address: __________________________________________________
        City: ______________________ State: __________ ZIP: _______
        Voice: (   ) _________________ BBS: (   ) _________________
        Wildcat Reg #:_____________________ BBS Hours: ____________
        Baud Rates:__________________ Fidonet Address: ____________

                       
                       Current versions as of 12/17/94

  PRICE               Door             VERSION                                                  
  -----            ---------           -------     
  10.00          Complete Page           1.03

  ________ Subtotal           

  ________ Tax (Md. Residents 5%)

  ________ Shipping Charges: Fido/Ripnet Netmail      No Charge
                             Download From My BBS     No Charge
                             720K/360k Diskette       $5.00
                             Credit Card Fee          $1.00
= ________ Total Enclosed (U.S. Funds only, please.)


Comments:___________________________________________________________
____________________________________________________________________
____________________________________________________________________
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* Credit Card Processing is available On-Line at Excalibur BBS. (301)434-5312
  (Visa, Master card, American Express, Savings and Checking.) 
* Check orders- check must clear before product will ship.
* Netmail will be HOLD mail unless it is a local call

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